We as the patients have some input to the price through demand, but not as much as you might think.
Certainly as a consumer of health care services we do have input as to pricing. But unlike a good or service that we routinely purchase, health care isn't a good example of a "free market" where consumers can shop around to determine the best price/value. We as a society in general are becoming more sedentary, older, more obese and voluntarily partake in activities such as smoking, drunk driving, and eating high sugar/fat diets. All of this leads to greater use of health care.
There are three major elements that affect price - supply, demand and costs. Diversity of policies is a supply issue, whether that is different kinds of policies, interstate competition or even access to different doctors. How we as patients use the system is a demand issues, how much we go to see a doctor, using urgent care over emergency room and choosing lower costing services.
No disagreement there except for the interstate competition, that already occurs.
I am convinced that cost is the major factor driving the price of health care today. It is expensive because stratificiation makes it expensive. You just cannot have so many companies in an industry and not have costs go up. Every layer adds their costs and profit to the pile and passes it onto the next layer.
The actual cost of health
care is indeed a major driver. That cost has been rising well before Obamacare. I'm with you on the complexity and the different firms involved. I live in PA, headquarters is in TX. My healthcare "insurance" (we self-insure) is provided by Aetna, managed by Hewitt, with Meridian as the payer, also involved are companies called AON, JIFF and Quantum Health. Each of those firms get their cut somewhere along the line.
A good article as to why costs are what they are is here:
http://khn.org/news/health-care-costs/We could afford our healthcare without our government, if it weren't for our government.
Not at all convinced of that.